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CITY OF D1Ab10ND BAR `�� COMAlUNITY DEVELOPhiE:r'T DEPARTMEhT ?-.-.. 21660 L.Coplcy Drive Suitc 190 (909)860�3195 fax(90'))861-3117 PRESS `~' AUILDING PERhi1T APPLICATIOt3 FIRMLY oN JOBSITE f�D APPLICATION�J..ZZ��J PERMIT f�jr /C ADDRESS�3 DATE ( � NUMBER��J x � ISSUE TypE pCC APN OT TRACT DATE CONST. GROUP p OWNER — �1 p ADDR S ZONING SEfBACKS Z CI _ ZIP TEL. REART RW O❑ g APPLICANT TEL. SIDEJSIDE STREC-T RW ❑ � CONTRACTOR R,B.I._In�,. SIDE ❑ � CDDRESS �Q� � TEL PROPOSED USE� G%�!OlG� O o ARCFilENG/ � A���' �z DESIGNER NO.DWEL. NO. NO. a ADDRESS UNITS STORIES BEDROOMS � CITY ' ZIP TEL. cn cn DESCRIPTION SO.FT. FACTOR PSF ADJ.AREANALUATION � ONRr'ER-BI:ILDER DCCLARATION SFIilADDAEM O W G1 HCREDY AfiIfU1 UNDCR iENALTY pF OEfWRY iHAT 1 A61 EZE4�T iR01I riiE CONTMC7di5 LI• Gi�i9B/G'fl0�1 CNSEU�MFOi11NCfOLLOWMGRC0.50N�5EL70]I.SBUSMICSSA�:DPHOFESSiOM1SCOCE.A4YCiYOR (n U �N7YW111GIREOURLSAiCRN'TTOCONSTRUCT,ALTERNFROYE,OCWl15H.O�qEVA:RANYSTRUC. 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